Pursuing Life's Greatest Lessons

Cat drama

2011-09-28T21:53:00.003-04:00

A few months ago, I rescued two kittens. They are so much fun to have around. I never thought of myself as a "cat person" but I appreciate the low maintenance cats require. With my schedule, a dog would have been a lot more work. Now that I know how fun they are, I wish I got cats sooner.

This morning, just as I was about to head downstairs when I heard Wes (the white cat) sequel and hiss. There was all sorts of commotion in the spare bedroom. I knew this wasn't going to be good. I rush in the room to find the cat hanging by his paw. I think he was sitting on the ironing board, which was by the open window. Somehow the cord from the mini-blind got caught on his leg. When he jumped down, it tightened around his leg and now he was stuck. At first I wasn't sure how the cord was tied and thought it might be around his neck by the way he was wrapped up and off the ground. I scooped him up and tried to pull the cord off his foot but it was to tight. Plus the cat was hysterical and wouldn't stay still. The sound he was making were terrible. Thankfully the scissors were in arms reach and I was able to cut the cord before he tried to jump off the ironing board again. But it was to late, the damage was done.

My left arm took the brunt of the damage. The worst of the cuts is on my hand, in the fleshy part of my thumb. Its pretty deep and bled for a while. I did my best to wash it off; while trying to make sure the cat was ok, who was also covered in my blood. I wish there was some way I could have gotten the cat to understand I was trying to help him and if he stopped clawing me he'd be alright.

I knew the wound was deep and needed a real good cleaning, so off I went to my doctor's office. She took one look at it and said its beyond what they can do in the office and sent me to the ER. Now I had a choice; go to the hospital I work at which was 45mins away or go to the one in town, 10mins away. Off I went to the closer of the two. Both are about the same size so I wasn't expecting a long wait. I was also a little embarrassed and didn't want the whole hospital I work at to know what happened. Especially if I was over reacting.

Maybe in hind sight I should have gone where I worked. Isn't it all about who you know? The care I got was fine but it took forever. The ER doc explained they were short staffed but as a paying customer I'm not sure I care. I know my injuries weren't a true "emergency" but you still want to feel valued as a consumer. The process in the ER doesn't seem to work. I tried not to use the ER as a doctors office but didn't have a choice. I know not to go to the ER unless you really need to. But still the process doesn't to be efficient at all.

At one point the doc said he was waiting for the lidocane and would be back in a few minutes. An hour later he came back. I told him I was just about to tell him to do it without the medicine because I was tired of waiting. I never saw a nurse until I was discharged and she came in to review the instructions. I know the data they track; left without being seen, door-to-provider time and then patient satisfaction. My guess, they failed on meeting those goals with my case.

Thank God my cat is fine. Imagine how long the vet would have been???

Moving Day

2011-06-26T09:43:00.002-04:00

Two weeks ago I moved out of my parents and into my very own home. This is the third time I have bought a place but this time there was a little more stress.

First, the rules for getting a mortgage have changed. Suddenly lenders are much more critical of who they are willing to lend money to. My credit was/is fine but the application has expanded and there is even more paper work to fill out. I felt like they were scrutinizing every financial decision I have ever made. Part of me feels like the lenders should have been more careful all along but that's just my opinion. It did amaze me how much money they were willing to lend me. I opted to stay on the lower end of that range since I don't want to be house poor and I'd like to be able to go out to eat, turn a light on and furnish the place.

The second stressful part was explaining why I spent a year working in Afghanistan. Apparently banks aren't eager to lend money to someone who as they said "had a real salary, didn't and do again." I was offended that I had to explain my choice. Yes, I agree it isn't something many people do. Yes, they do need to be careful in who they lend money to however doesn't my financial history demonstrate credibility? It must because they gave me a mortgage or maybe they aren't as stringent in their lending decisions as they would like for us to believe.

The move went well and many thanks to the friends that helped.

Its been exciting to unpack and get settled in. My stuff has been in boxes for almost two years -it was a little like Christmas opening each box. I forgot what I saved. Only a few times did I ask myself "why did I save this?" Its also been fun to buy the stuff I sold or gave away; couch, chair, plates, silverware and TV.

The picture is of my first uninvited house guest. Last weekend I was sitting on my patio and a wild turkey came down to welcome me to the neighborhood. I am so thankful for my new place. Its more then I expected and I truly feel blessed. I am looking forward to living in this town and in this house for as long as this chapter in my life will be.
Keep Smiling

Artifacts

2011-06-04T15:50:00.002-04:00

I've been at my new job for 4-months and finally don't feel like a tourist anymore. When I was in pre-field training for Afghanistan the facilitators talked about how it takes 3-4 months for you to start to feel like you "get-it." You develop habits and start to settle into a routine. The danger is, the excitement wears off and you realize "jeez this is my life." When that happens the things that were "new and exciting" can become little stresses that wear on you.

I would say I have adjusted to the 45-minute drive. Its a pretty drive and the biggest traffic issue is getting behind a school bus on Rt 6. I count the hawks and the dead deer on the side of the road to pass the time. It still amazes me that there are dead spots for the satellite radio along the way and it never fails that I hit these spots during my favorite part of a song or during the most interesting part of a news story.

It's been a interesting few months as I learn to navigate the waters of working in a small rural community hospital. This is a good fit and I am going to get a ton of experience. It seems like everyone has either worked there 100 years or less then 5 years. Just about everyone is related to someone who works at the hospital, except for me. When I first started, they pegged me as the "city girl" since I live near Hartford. That made me chuckle because I wouldn't consider Hartford a major metropolis. But compared to the quiet northeast corner of CT, I guess it is. It is a very different environment then working in a teaching hospital. Not better and not worse, just different and equally as challenging.

Some of the challenges are the same when compared to Kabul; such as a very limited budget and the poverty. The poverty isn't as extreme but a large portion of our patient mix are under insured or self-pay. We struggle to maintain a census and are looking to grow those programs that generate revenue.

One thing that has been amusing is figuring out the nuances or artifacts of the women's bathroom. In any "culture" there are those unspoken rules that we are left to figure out on our own and the ladies room on the 4th floor as its own set. There are two stalls and at first look, nothing stands out. They look like average stalls: doors lock, toilet and toilet paper. But it appears only one person is allowed in the whole room at a time. Which begs the question, why the two stalls?

One women, locks the main door every time she goes in. I learned that the hard way by walking into the door because I was expecting it to open and it didn't. A few times I have been at the sink washing my hands when a second women came in and very awkwardly said, "I'll let you finish" and turned away and walked out. I don't understand, I was just washing my hands. And just yesterday someone walked in and when I flushed they walked out. Maybe there is a schedule and I'm only allowed to go at certain times? Who knows.

Keep Smiling!

Debriefing

2011-04-30T11:29:00.003-04:00

End of January I went to Colorado Springs for a week long debrief. I was supposed to go in November but the class was filled. Wasn't able to go in December because of the holidays they didn't offer one. The "rules" for the debrief were we needed to disconnect from the world and be in the moment. We needed to use this time for us and focus on us. During the day they encouraged us to not check emails, turn our phones off and really pay attention.

I was not looking forward to going. Excited to travel and be back in Colorado but not looking forward to what I knew this week would involve. I called a friend from the airport who I worked with in Afghanistan and had gone to pre-field training with. She's back in the States and she told me this week "would be like a good enema, uncomfortable but in the end you'll feel a lot better." My friend isn't a nurse but as a nurse I really appreciated the analogy. It ended up being the perfect description of the week. It was uncomfortable to talk about all I saw but in the end it was exactly what I needed.

There were about twenty people in the class. One of the couples had been working in Afghanistan, I had actually met them while I was there as they were passing through the city. Another couple who worked w/my sending organization but if a different country and a couple who I had been at pre-field training with. It was great to see them. The rest were people who had been all over the world working for various lengths of time.

We laughed a lot. We cried at times and we learned a ton. It was amazing to be with so many people who really knew what it was like. Who really understood how this experience has changed my world view.

One couple had been working in a country for 4-months when the husbands life had been threatened and they pulled the whole family out. Her and I spent a lot of time talking during the week. He joked with me that I was the crazy one for working in a war zone. I thought he was crazy because he brought his children to live in the jungle. Guess its all relative.

The week was just what I needed before I started my new job. I can't articulate fully how being able to debrief and really talk about it helped. It still is helping because now I feel like I have to tools to be gracious with people around me when we can't understand each other.

It's been much harder to be back then it ever was to go. I was really excited to go and being back didn't make sense. I was and am very glad to be home. But it wasn't what I expected. Oh well, life isn't what we expect. Hahaha.

Keep Smiling!

I got a job!!

2011-01-11T00:37:00.003-05:00

Whoop Whoop, let the celebration begin! The waiting is finally over. I accepted an offer to be the Director of Nursing at a hospital in Connecticut. I'll start next month. I am extremely excited and a little nervous. Its a big responsibility but I think it will be a good fit for me. I agree with the hospitals mission and vision and am excited to bring their nursing department to the next level.

My parents, my sister and me all had a little champagne toast to celebrate that my retirement is over. It was fun to be able to enjoy the good news with them. The timing was perfect.

Its a little switch over working in Kabul but the patient population is diverse in its socioeconomic status, which excites me. The hospital is involved in their community and who knows what opportunities will present itself.

Now I have to decide where to live, and if I should rent or buy. But before that I have a trip to Colorado planned for some de-briefing and then a vacation in Hawaii!! Which is just a little treat to myself.

Keep Smiling!

Waiting is the hardest part

2011-01-05T13:45:00.003-05:00

Still waiting to hear about a job. Trying to be still and enjoy this time of rest and refilling of my cup. Yes there are some perks to staying up late, sleeping till 10am but it sure would be nice to have job. The danger with my current circumstance is I am starting to feel like I'm running out of motivation to do anything. I'm also a little worried I may have forgotten how to do my job.

The week before Christmas I interviewed at two hospitals. With the first facility, this was my third "call back". The first interview occurred in Nov. The process has moved forward and the communication between them and me has been decent. The second facility conducted the interviews in a day and a half. I haven't decided which way is better. Get it all done in a day or have the process carried out over 6-weeks. The one perk to the 6 week process was I felt like they must like me since they kept calling me back. The perk to having the interviews occur all in one day is; it's only one day and I only had to wear one suit.

Both places said I'd hear after the holidays. I know one place has contacted at least one of my references. As for now; I wait, I sit still and rest. I am also truly thankful that my circumstances don't require me to just take any job that comes along.

Keep Smiling!

Scared the daylights out of me

2010-12-14T19:32:00.004-05:00

At 0330 this morning the family dog, who has taken to sleeping next to me jumped off my bed. She takes off down the stairs barking. I sit up in bed, eyes wide open and my heart racing in my chest. I suddenly develop supper sonic hearing abilities and am straining to hear anything.

A thousand thoughts running through my head; why didn't I get my pistol permit, should I call 911, my parents are down the hall sleeping, why didn't my dad get up and the list goes on.

Several minutes later the dog comes back. I am laying there trying to convince myself that she scared away whoever or whatever made her bark. The dog jumps back up in bed with me and I nervously pet her head. Just as I am about to lay my head back down to bed, her ears perk up, she growls and I hear a man's voice down stairs.

At this point, my heart has gone from racing to pounding in my chest. I hit the dog on her back end and tell her "go get 'em". We both jump off the bed, she goes downstairs and I take off running down the hall to my parents bedroom. Throwing open my parents door, in a loud whisper I say "WHERE'S DADDY?" My very disoriented mother answers "downstairs with the guy from the gas company we don't have any heat....why what's the matter with you?"

I jump into their bed, throw my arms around her and exclaim that "I thought someone was breaking in." I didn't know if I wanted to laugh or cry. Like all good mom's she gave me hug and sent me back to bed.

In my defense, after being in Kabul for a year, my senses are still a little hyper-vigilant. And, I watched Dr.Petit speak on Oprah last week (family brutally murdered several years ago; occurred in suburbs of CT around 0330).

Keep Smiling!

The search continues

2010-12-10T20:23:00.003-05:00

Searching for a job, takes a lot of energy and perseverance. It's not for the faint of heart and interviews are mentally draining. Officially I've been unemployed or as I prefer to call it, retired since Oct 1. Not horrible considering the current state of our economy. I also have elected not to collect unemployment. Thankfully I am in a position where I don't need it. My parents are letting me live with them rent free and I don't have debt. In addition to that, a few short term opportunities such as editing an article for publication have presented themselves so I've had spending money.

I have been on a few interviews for either consulting opportunities or full-time employment, which I am truly thankful for. Again, given the unemployment rate I feel pretty blessed. I have greatly appreciated the time of rest at home as I've been adjusting to being back in the States. I needed that much more then I ever dreamed.

With that said, its going to be quite the shock to my system when I have to rejoin the workforce. Unless I can find a job that lets me start at 11am and wear slippers, but I'm doubtful. I used to watch the Ironman Triathlon that occurs in Hawaii and think the only way I could do that was to quit my job and train full time. Well, I haven't used this time home to do that. Although if a job doesn't happen soon, I may reconsider that option.

As of today, I have two interviews scheduled. One will be my third interview with the facility. The second is a two day interview with another facility. There is a third facility that reportedly wants to interview me but has yet to schedule it.

All of these opportunities are in the States. I haven't seen an overseas opportunity that pulled on my heart like Afghanistan did. Felt a twinge for an opportunity in Haiti, so maybe that part of me isn't dead. Here's to hoping I am employed at Christmas.

The photo is of the mountains in Kabul. It was taken from the plane as I was flying home.

Keep Smiling!

Home Depot and random thoughts

2010-12-07T18:37:00.004-05:00

Spent some time today in Home Depot. Its not usually a place I shop but my youngest sister and I ran there to get more white Christmas lights and a Christmas present for our dad. He's asked for two "man" gifts; a case of oil (also helpful for us since he changes the oil in our cars) and a new shop light.

Now if Home Depot was interested in a few suggestions, I'd be willing to offer some. First, as an independent women, I won't be offended if you come over and ask me if I need help. Especially when my sister and I are starring blankly at all the options you have for fluorescent lights. The second suggestion is, it might be helpful to put the light bulbs that go with specific types of lights in the section that the lights are sold in. There are a lot of different types of bulbs. The best idea would be to sell the lights with the lights, but that might make things to easy. Does anyone know what's the best way to wrap a T8 32watt 48 inch bulb?

On the way to Home Depot, I stopped to get gas. $3.09 a gallon -Yikes! As I was putting gas in my car and wishing someone would do this for me, my mnd wandered to life in Kabul. It's cold in Connecticut and since my Kabul experience, I really really really dislike being cold. I realized that one of the things I miss about Afghanistan is not having to do the car maintenance. I wasn't allowed to drive, which was probably a good thing since traffic is a nightmare, as are the road conditions. Not driving also means, you don't have to put gas in the car, take it in to get the oil changed and that the car is already warm when you get it in.

Keep Smiling!

Thanksgiving

2010-11-29T23:30:00.002-05:00

What a treat to be home for Thanksgiving this year. We had a small crowd, just immediate family and one guest. Spent the day before baking all the favorites; banana cream pie, chocolate cream pie and apple pie. Then made deviled eggs, which are much harder then one would expect.

Throughout the day I couldn't help but remember what last year was like. The four days before Thanksgiving we didn't have power, which meant no heat and no hot water. I was so miserable on Thanksgiving morning. All's I wanted was a shower before we headed over to the base. We had been very lucky to score an invite to dinner at the military base, and I would have given anything to wash my hair. Little did I know that this was only the beginning of what winters were like in Kabul.

Dinner with the troops was a blast. As an extra perk, the UCONN game was on TV while we ate. And boy did we eat. This was the first time since I arrived in Afghanistan that I had American food. We even had real ice-cream.

Since I've been home, I feel much more patriotic towards the men and women in the armed services. I've always supported the troops but its different now. I feel we can't do enough for them. My heart truly goes out to them, their families and the sacrifices they make to for me, us.

When we got home after Thanksgiving dinner, we had power. I was able to take a warm shower and then headed out to have a second Thanksgiving dinner with some friends at "J" compound. Both dinners were nice, but nothing beats being with your family.

I am so thankful to be home.

Voting Day

2010-11-02T19:11:00.003-04:00

America, the land of the free!! Remember to celebrate our freedom, liberties and go vote.

Last year I wasn't in the States when it was election season. The perk is you are away from the phone calls and spam that arrives daily in your mail box. In Kabul, they plaster walls with pictures of the candidates. Banners are hung throughout town and like here, the conversation around the water cooler is political.

Unfortunately today, I wasn't able to vote. There was some paperwork error that occurred. Before I left for Kabul, I sold my house and moved in with my parents for 2 weeks. I completed all the necessary paperwork to change my address and my voting registration. Today I showed up at the polls and there was no record of me living at this address. I did notice that I wasn't getting any political pamphlets but it didn't register that maybe I wasn't registered.

After I few phone calls made by the official voter dude, he told me that yes my voter registration was canceled in my previous town of residence but they have no record of it being transferred to any town in Connecticut. He did give me the paperwork and allowed me to fill out a new voter registration form but I wasn't allowed to vote today.

I'm pretty angry with myself. The right to vote is such a privilege and I blew it. I believe that one vote does make a difference. I believe that we need to take this right seriously and vote in each election as an informed voter. And I think its extra important for women to get out and vote. There are still too many countries where women struggle for this right, we shouldn't take it for granted.

Keep Smiling!

Orchard

2010-10-10T23:29:00.003-04:00

One of my favorite fall activities is going to the orchard to get apples and a pumpkin to carve. My mom, youngest sister and I all went this weekend. We sort of cheat; we don't actually pick the apples. We buy ones in a basket that someone at the Orchard has already picked.

Selecting a pumpkin is tricky, especially when you don't have an idea on how you want to decorate it. Some years I get a small one or one with a dent, depends on my mood. This year I went for a medium sized one that I can carve. The plan is to attempt to make a pumpkin bread with the insides. Never done that before. My sister selected a white pumpkin. I don't remember ever seeing an all white pumpkin. She's not sure how she is going to decorate it either.

One of my other favorite activities is getting warm apple fritters and hot apple cider. I missed this last year. One of the things that was challenging about living in Kabul is its brown, year round its brown. It's so sad. Aside from when the flowers bloom, there is very little color or vegetation in the city. At least the flowers are in bloom spring, summer and fall.

Keep Smiling!

The Job search

2010-10-09T00:23:00.003-04:00

Having officially completed my assignment on September 30th, I like to consider my self "semi-retired". I think it sounds better then unemployed.

Thankfully prior to leaving for Afghanistan I paid off all my debt; sold my house, paid off my car and any credit card debt. I'm living with my parents as I search for a job.

It's a little unsettling not having a job. Now, I recognize it hasn't been that long but I started seriously applying for jobs in mid-August. I interviewed for a position at one hospital in CT that started off as a consulting job, changed to a temporary employee job and then finally became a permanent position. As a consulting or temporary gig, it was great. Unfortunately as a permanent position it was a little too far off my career track and to many steps backwards.

I have since interviewed for a position in DC and had a phone call with an HR person from a hospital in PA. Both of these options are intriguing. With DC, I am waiting to hear if they will offer me the job. With PA, I am waiting to see if Senior Management wants to schedule an interview. While I am waiting; I have applied for jobs in Connecticut, California, Maryland and Texas. The waiting is the terrible part. During this process, I have become less and less a fan of the statement "we will contact you if we are interested in arranging an interview, please do not contact us."

With both DC and PA, it was a month after I applied before they got back to me. Can companies quantify when they will get back to an individual? Say something simple like, "if you don't hear from us in 4-6 weeks, we have decided to pursue other candidates." As the self appointed voice of the "semi-retired" I believe those of us looking for jobs, want to know when you don't want us.

Some places will let you search the status of your application. This is a nice feature. I have learned from one place they have reviewed my resume and passed it on to the hiring manager. Two other places have said they reviewed my resume and its been declined. Declined is a little harsh but at least I know.

Keep Smiling!

Change of Plans

2010-09-08T22:44:00.003-04:00

It has been a wonderful 6-weeks of vacation. I have enjoyed the time to reconnect with friends and spend some quality time with my family. We went to Cooperstown NY and visited the baseball hall of fame. Which I highly recommend that all baseball fans go and see at least once.

This past weekend we went up to our cottage in New Hampshire. Hurricane Earl made for a windy few days but aside from that it was a great time of rest and relaxation. My father and I spent some time fishing on the lake. I was able to convince my Dad to put the worm on the hook the first time. Yes, I'm a nurse but I don't like touching the worms. They won't stay still, they are slimy and I'm afraid I'll stick myself. The second time I needed bait, I had to do it myself. And let's just say I don't have a career as a bass master fisherman. Over all the fish ate well that night; we did manage to catch a few sunfish, perch and a cat fish. We released them all back to become even bigger fish for us to catch next summer.

During this time home I had to make a decision about what my future holds. The big question was am I going to go back to Kabul and if I do for how long. I have decided not to return. I will remain on staff until at least the end of this month and will function as a mentor/resource remotely until a replacement can be found.

This was a very difficult decision to make, probably much harder then you would expect. I have enjoyed the comments from people as I have explained that I wasn't returning and hope my responses have been kind. I am aware that most people think I was insane for going in the first place.

However I don't feel that way. It was a wonderful experience and I have no regrets about going. I learned so much about myself and what is truly important in life. This experience has changed me in both positive and negative ways. I met some wonderful people both westerners and local nationals.

Living there for a year has given me a much better understanding of Afghanistan and the complexities of life for the Afghan people. After seeing what I saw and experiencing what I did, I will be a greater advocate for the rights of Afghan women and children. I am truly grateful to have been born in America . Yet Afghanistan has become a part of me and has changed me forever.

I do look forward to the day when I stop diving to the ground at loud noises. I still struggle to watch TV shows that are action/adventure. And please don't ask me if I think this war is winnable, I didn't spend any time with McChrystal or Petraeus. Just trust me, it's a very complicated problem and be thankful that you don't have their job.

As for what's next, I have no idea. I do plan on keeping the blog. I have sent out a few resumes and will see what doors open. The world is my oyster which is both exciting and a little nerve wracking. We shall see what adventures are next.

Keep Smiling,

Jen

They paid the greatest price

2010-08-07T21:14:00.003-04:00

This morning my day began early with emails and Skype calls about the 10 medical aid workers that were killed in Afghanistan. Friends in Kabul wanted me to know that this attack was different, the names of these victims were friends. Co-works in a sense. I am truly heart broken.

Like them when I volunteered to go, I knew there would be risks. However, it still doesn't lessen the impact of the news. Can you ever be prepared for something like this? This news is devastating.

One of the men, him and I flew into Kabul together. It was only a year ago. We were both newbies. We had spent a few days in Dubai. We sat for hours together in the waiting room at the consulate chatting about the projects we would be working on, what we thought life was going to be like and wondering if we would ever be able to learn the language. Later that evening we ordered take out and just hung out. We didn't know what else there was to do. Then the next morning, we boarded the same flight into the sandbox. It was so comforting to have a buddy that was as new to this as I was. Throughout the year we would run into each other at various events and chat.

One of the men is the husband of a co-worker. The last time we had dinner together he was talking about this trip. That was three weeks ago, the last time I saw him.

The others, I met as the months went on. Invited to lunch, friendly hello's at the bazaar. It's overwhelming to think about it all.

My thoughts and prayers go out to their families. My poor friends still in Kabul, you are also in my prayers. I am sending big hugs your way.

I keep asking; why, how and why? Words like senseless, evil and horrific keep coming to mind. Like me, they came to Afghanistan to help the people. Unlike me, they paid the ultimate price.

The Transition Back

2010-07-30T09:56:00.003-04:00

I've been home a little over a week and its strange to be back. I'm glad to be home and need the rest but it's strange.

I've enjoyed getting my haircut, going out to dinner in restaurants where there aren't armed guards and seeing all the choices in the grocery store. Being able to drive, walking outside and being able to make eye contact again with people on the street was something I didn't realize I missed so much. The color here is amazing and its not even autumn. Kabul is brown, year round. When we drive, I can see houses; in Kabul all the houses are surrounded by 12 foot high walls and barb wire. Did I mention how much I enjoy the lack of dust? The simple things that I used to take for granted, all have new meaning. For example, I really enjoy not having to brush my teeth with bottled water!

Being home has brought some challenges as well. I'm not the same person I was when I left a year ago. Its hard to quantify the ways I've changed, just like it's hard for my friends and family to tell me how they have changed over the year. Its easy to talk about the new technology and fashion trends but on the inside I feel different.

It's like I have two separate lives both with equally important aspects to it. My friends in Kabul became my family, there is a closeness in our relationship because no one else experienced what we did. I miss them. I can't wait until their home and we can joke about how bazaar it is to transition back to civilization because I feel like an alien in my own country.

Keep Smiling!

Reflections

2010-07-12T13:35:00.003-04:00

I'm getting ready to head home for my annual leave, after 11 months we get 30 vacations days. I am so excited to get home for such a long period of time. I cannot articulate the feelings; its both exciting and a little intimidating. Exciting because it will be so wonderful to be with friends and family, intimidating because life here is different - like being on another planet kind of different. Either way, I am looking forward to being on vacation and being home. Hope coming back isn't hard.

When I look back, in some ways, it feels like I arrived yesterday. Yet in other ways I feel like I have been here for a life time. We've been talking these last few weeks about lists -"to-do lists", "bucket lists" and lists of joys. In the spirit of knocking things off my to-do list, I decided to list my blog entry this week would be reflections of the year.

Aug - 3 weeks of training, say good-bye to friends and family. Crazy man on plane who yelled at me b/c I took his overhead compartment, leave my pictures in Heathrow.
Sept – US army arrive at the house, start to decorate my new apartment. First time on Cipro. Begin to learn the names of the 100 staffers who report to me.
Oct – 7.2 earth quake, UN guest House attacked, kangaroo room incident. Tense situation at a checkpoint. Trip to Istaliff, CNN visits hospital
Nov - Explosion on my birthday, can't go for brunch. Meet new people at weekly BBQ's. Thanksgiving at Army base, no power for 4 days, up late writing a proposal with the team.
Dec – 4 of us have to go to Dubai to get a visa, 2 weeks of running the hospital by myself because everyone else was on leave, had a skype Christmas, learned how to play poker, vacationed in Dubai, moved
Jan – spend New Years in the dessert, have to get another visa in Dubai, had vertigo and passed out in the shower.
Feb – Move, freezing cold, begged for a cook, got over my fear of lighting gas things, basking lunches at the French Cafe.
March – NICU overflows, weather changes, team members back, different team member leaves, surprise friendships
April – volcano, surprise trip home, find grenade at hospital, roses blooming in the garden
May – Explosion 200 yards away, new volunteer arrives, dollar decreases, networking dinner for Fistula
June – more visa issues, unusual staff requests, advocate for raises, peace Jirrga, ring of steel signs, ants in the kitchen
July - 4th of July in Dubai, new visa, Fistula Hostile almost completed, new boundaries, Kabul Conference...a time of reflection.

See ya soon.

Keep Smiling!

Lady Taxi

2010-07-02T16:09:00.002-04:00

I'm in Dubai to try and renew my visa. The contrast between Dubai and Kabul always amazes me. Its going from one extreme to another; extreme poverty to extreme wealth.

Getting off the plane and leaving the airport the humidity slaps you across the face. By this time I have already stuffed my headscarf deep in my bag and am thankful I opted to wear linen pants. I may look like a wrinkled mess but they aren't sticking to me.

Getting a taxi at the airport in Dubai is one of the most organized processes that I have ever observed/participated in. As you walk out the exit for taxi's, you are ushered into a well formed line. There are line markers which prevent crowding, like in an amusement park. As you look ahead you can see dozens of taxis all in a line waiting. When you reach the front of the line, a uniformed man directs you to your taxi. As one taxi pulls away the next one drives up to take the next person. It really is efficient and moves pretty quickly. Which is nice because this time of year, standing outside side feels a little like you are melting.

This time we were directed to a "Ladies Taxi." It was the cutest thing. I've never seen this before. The lady taxi driver, was standing near her taxi talking with another women who worked for this cab company. Both were wearing a pink and white uniform. The cab instead of being like a yellow cab in the States, was pink and white. It was adorable.

The women explained that the company has been around for the last several years and is now up to fifteen drivers. It wasn't clear from her explanation (I had a hard time understanding her accent) but I think the cars are only used to transport women. It's an interesting concept. I remember when I was in Egypt there were women only subway cars. It seems like a safer way to travel but I wonder if feminists all over the world will think this is a set back for women's rights. But I can tell you, this service would be a hit in Kabul.

Keep Smiling!

De-Mining

2010-06-27T04:08:00.002-04:00

A few weeks ago there was a hand grenade found on the property of the hospital. It was in the back, near the area we are going to renovate to be our fistula hostel. It was a little disturbing to think that I had recently been walking in that area. We have no way of telling if it was new or if it has been there for years. With the history of this country who knows.

Not only did this delay the renovations but we had to find someone to come and make sure we didn't have any more unexploded devices on the property. Again, a little disturbing but I guess this is normal when you are working in a war-torn country.

We followed the typical process and put the project out to bid. Three company's gave us estimates and we selected one. After we selected a company, they offered to do the work for free, as a donation. That was real blessing since this project was not something we had budgeted for.

When the guys showed up it was a little like the movie "Hurt Locker." They blocked off the area and went about their business. It took 4 days and they found another grenade, some unexploded small arms and an unidentified device. They didn't find any mines and based on the history of the area they didn't expect to. We will be fencing off the area that has not been done and putting up signs that the locals will recognize. These signs will say that beyond this fence the area may have mines or unexploded devices. For now they put blue rocks out to mark the area. Again, these rocks the locals will recognize that the area beyond them may not be safe.

The project didn't impact hospital operations much. The supply shed is near the area that they were de-mining so when they guys were working (6a-2p) we were not allowed in the supply shed. Aside from that, life went on as usual. If finding grenades at work can be considered normal?

Keep Smiling!!

2nd Visit to the Club

2010-06-27T03:51:00.002-04:00

I went to cigar club at the Embassy again. This time it was a more formal meeting. The Chaplin still wasn't there so another gentleman opened the meeting in prayer. After the prayer, new members were introduced (I have not joined) and then they explained the cigar of the day. The only thing I remember about it was the cigar wrapper was made in CT.

There was a lesson on humidors. I learned that humidors shouldn't be placed in the garage, basement or attic because the temperature fluctuates to much. Its best to keep your humidor in your house. After the lesson there was a raffle. I bought five tickets just for fun. The prizes were lighters, cigars, a cigar carrying case and the grand prize was a mini-humidor. Turns out I won -twice!! The first time I won a cigar called a Monti-crisco. I about died it was so funny. They called my number and I cried out "Oh my God." The guys I was with were laughing. They laughed even harder when I won the second time and it was the cigar carrying case.

Well now I have a case for my one cigar. I did promise the guys that maybe on my last day in country I'd try the cigar I won. For now one of the guys has it in the humidor he had shipped over.

Keep Smiling!!

My Burka and me

2010-06-20T10:46:00.002-04:00

When I first arrived, someone mentioned that I should get a burka. After almost a year, I finally got around to getting one. They have to be specially made, with specific fabric. The shop measures your head and your height. From what the shopkeeper said, I’m pretty tall. I guess I never noticed but I am taller then most of my female staff. Most of the burka's in Kabul are blue, occasionally I'll see a white one. I'm not sure if the color is significant.

I have only worn the burka around my flat, figured I needed to practice walking in case I ever have to wear it. There is a mesh square that you look out of and I find it difficult to see. I have no peripheral vision. I have to wear my ponytail at the nape of my neck so the burka fits properly on my head. In the warm evening air, it’s hot to wear. I can’t imagine what its like during the middle of the day. Nor can I imagine what it's like to have to wear one or you can't leave the house.

Even though it’s only around my flat, I feel uncomfortable wearing it. Maybe even a little invisible? Walking around the hospital I see many women wearing them. I can’t tell if they are looking at me but I always try to smile and say hello to them. I want them to know that I see them. I imagine that they are smiling back but I suspect maybe they are wondering who the crazy foreigner is saying hello to them.

Keep Smiling!

Cigar Club

2010-06-07T12:36:00.002-04:00

A few of the guys I have met here invited me to cigar club. I don’t smoke but figured it would be fun to check out. Plus this meeting was at the US Embassy and I have never been there.

The Embassy grounds are beautiful. After getting through all the security checks, we walked through what could have been any small town in America. They call the houses “hooches,” they are essentially containers. Each container has its own heater/air-conditioning unit and inside there are sleeping quarters, a bathroom, living room and small kitchen area. In front of each container there is a tree, a small patch of grass and some flowers. Walking to the gazebo where the club met was like walking through a small neighborhood. I wish we were allowed to bring camera's inside because those images are unseen in this city. No grass, few trees and no sidewalks.

Cigar club was almost exactly what you would expect; a group of men sitting in lawn chairs smoking cigars and chatting. The only things missing were a grill and a keg. If it wasn’t for the cigar smoke, you could have smelled the testosterone, LOL.

This wasn’t a typical meeting because everyone had been on lockdown due the Peace Jirga. Usually they give out the cigar of the day and provide information on the type of cigar and other misc information. It would have been interesting to learn a little more about cigars. There was no raffle either. But they did pray, which surprised me.

I was embarrassed when we arrived because they introduced me as a nurse and there was some comment about bringing a nurse to cigar club. In general everyone was nice and it was a fun afternoon. The guys I was with are in law enforcement or are attorneys and I enjoyed hearing about their jobs.

If I’m invited back, I’d go again.

200 yards

2010-05-22T02:25:00.003-04:00

The day (May 18th) started off like any other day; the sun was out and the sky was clear. It was so clear that you could see the mountains behind the hospital and you had a little skip in your step. But at 8:10am everything turned chaotic. I was in my office meeting with two supervisors when there was a heart rattling sound that blew open the windows in my office. Before I even realized what happened I was on the ground next to my desk, along with my supervisors.

I recognize the question was silly but I couldn't help but ask if that was an explosion. My supervisors responded with a "yes" as we were getting up from the floor. Some how I gained composure and asked them to return to their wards and make sure everyone was OK. As we all left the office, there was a crowd of visitors and staff gazing out the long window in the hallway. When I looked, you could see a black ominous cloud billowing up just behind the building next to the hospital. There was also a sound of small arms fire, which later we were told that may have just been the ammunition in the convoy exploding. The incident took place just 200 yards from the hospital.

I made the rounds and discovered everyone (visitors, staff and patients) were OK. Several windows had been blown out. One very thankful patient had just gotten out of bed when the glass blew on to her bed. The supervisors and I went out front and we began to set up a little triage/first aid station near the front gate. We held all surgeries in case we needed the operating rooms but no one came. A few patients with minor injuries went to our Family Health Center which was set further back from the blast site. They were unable to save a pregnant women who woman who had to be extracted from the bus that was close to the blast. I felt like I was living an episode of MASH.

By 10am everything was over and we all attempted to gain some control over our day. Almost as as cruel joke, the clouds turned black and a thunderstorm blew in. It started to hail, the size of moth balls. With each crack of thunder I couldn't help but wonder if this was the end. What was next a plague of locusts?

The storm blew out by 3p. And then maybe like Noah, I needed I promise that things wouldn't be destroyed and I noticed the rainbow.

Keep Smiling

It took a volcano

2010-05-17T13:27:00.003-04:00

It took a volcano but I was finally able to go home for a visit. I may have missed my conference and an opportunity to tool around Austria with friends, but going home was just what I needed. I didn't realize how much I needed to rest until I was home doing just that.

There was a slight bit of culture shock as I adjusted to being home. The first thing I noticed was being able to drive and that there are actual rules of the road that people follow. When I wasn't driving, it took me a while to get used to being allowed to sit in the front seat. The entire time I have been in Afghanistan, I can only think of one time I sat in the front. I'm not even sure that time counts since it was on my way from the airport when I first arrived.

The cost of fresh fruit and vegetables shocked me. But here, I pay $9 for a box of cereal, maybe $1.49 per lb of banana's isn't bad? I had a mini melt down in one store as I was trying to buy some pens to bring back. I haven't seen so many choices for things in a long time. Here, you buy whats available and are just thankful if you get a choice.

Some may call this culture shock, others may think I have PTSD. I was sitting at a traffic light and as a motorcycle drove by, it back fired. Before I knew it, I ducked behind my steering wheel. I also found it a little hard to get dressed. Suddenly skirts that come to my knees feel very short and when I tried on a sun dress, I didn't think I had enough clothes on.

It was a fabulous time at home. I feel recharged and ready to face the next few months. It is an adjustment to be here. I miss the water pressure I had at home. Wireless internet, I had forgotten how amazing it was. And consistent electricity, need I say more? I enjoyed my time at home; being allowed to walk around and not be a spectacle is a true gift.

International Women’s Day

2010-04-03T08:35:00.002-04:00

I had never celebrated International Women’s Day before (March 8^th). When one of the female physicians and a midwife approached me about organizing an event for the hospital, I agreed to help.

The plan was to have a raffle, read poetry that would inspire and encourage women and have our hospital executive director give a speech. The entire event lasted an hour but what a truly inspiring time.

It was exciting to see the women at the hospital celebrate and encourage one another. Our hospital staff consists of slightly over 300 employees and about half of them are women. As a western woman who has been afforded so many rights and privileges, there have been days that I get frustrated because rights and privileges are different here. I have seen and experienced a few situations in the last few months that make me appreciate what the women who fought so hard to guarantee my right to an education, to vote and to be able to make decisions regarding medical care went through.

International Women’s day was inspiring and I was glad I was able to celebrate it with the female staff that I work with. I look forward to the day when there is less disparity in the rights and privileges for the women in this world.

A Baby Explosion

2010-03-20T13:09:00.003-04:00

Our sick baby ward (like a Neonatal Intensive Care Unit -without the technology) was designed to hold 12 babies maximum. Two weeks ago we squeezed in 19, it was unbelievable. There was no room to move, everywhere you looked it there was either an isolette or a bassinet. All week we had been approaching our limit and then on Thursday night there was a baby explosion. We hovered abound 16 babies, hoping no more preemies were born but then it seemed our luck ran out; one set of twins and a single preemie.

When I review our trends, we appear to be having the same number of births at the hospital but the number of premature babies is higher. We average about 200 deliveries a month and for March we are right on track. I don’t know what’s in the water but things on the maternity ward and in the sick baby ward are insane.

The staff has been amazing! A few days ago we identified an overflow space –a large storage room incase we needed it. Thankfully the room is just down the hall from the current space. Thursday late morning, the facilities staff moved everything out of the storage room, added a few more outlets and the housekeeping staff came by to clean. Shortly after 6pm and we shifted five babies over.

Having such a quick change in our census made a minor staffing problem on the ward to a major staffing problem. Typically we staff two nurses in the sick baby ward, which by western standards we should staff more. This was the staffing plan I inherited and since I have arrived we have been looking for ways to have a better nurse to patient ratio. But I am having little success in hiring someone who wants to work in this ward. Thankfully the staff volunteered and everyone picked up some overtime during this week.

Thankfully, with the overcrowding there were no negative outcomes. We did not see any baby develop an infection and the one baby who passed away had a cardiac defect that we could not repair. It was a true miracle.

The overflow space was open for a week and now we are back to our “normal” 10 babies –THANK GOD!!

Safe?

2010-02-26T05:35:00.002-05:00

Answering the question “do I feel safe?” is a complicated one. I have spent almost six months in country and if I am counting correctly there have been four “major” events in that time. In some ways I’ve become cynical as I try to cope with the fluid security situation. However I am starting to wonder if maybe I have become like the frog in the pot of hot water and I’m not noticing that the water is starting to boil. When I talk to folks who have been in country for a lot longer then me they say this is status quo, one event every other month or so. I think they mean for this to be reassuring.

Now when I made the decision to come, I was as aware as one could be about the security situation. In pre-field training they encouraged us to decide ahead of time what situations would cause us to evacuate. I gave it some thought but didn’t develop a list of what that would look like. Maybe foolishly I figured I’d just know when it was time.

With each event I wonder, “Is this the event that will send me home?” Today was the first time I actually felt and heard the impact of an explosion. I’m not sure I can articulate the sound or describe what it felt like. I was sound asleep and woke up with a start to a terribly loud boom. Then it was followed by an eerie moment of nothing. Within seconds I was out of bed, putting on clothes and shoes I could run in if I needed to. We headed to a room with no windows and waited. We waited for about an hour.

Everything is back to normal except we are on lock down for the rest of day. Left to go about doing things inside and “the travel situation will be re-evaluated tomorrow.”

So here I am, wondering, “do I feel safe?” Today even after what happened, I can say yes. Not as confidently as I would have yesterday but I don’t think this one will send me home.

Texas Hold 'Em

2010-02-15T03:29:00.002-05:00

I have learned many things since I have lived here. One of the most enjoyable skills has been learning how to play Texas Hold’em. When I was living with some other folks, they taught me how to play. Now we play about once week; it’s low key, fun and truly no pressure. No one talks work; we joke around and chat about current events. Everyone wants to win but the real goal is not to be the first one out.

Prior to coming here I had played once, maybe twice so I was a little apprehensive to join the game. Especially since the first night I played I was the only girl. But the guys were great and gave me a little cheat sheet of what cards beat what. Their support and encouragement ended when I won the first two nights I played. Especially the second night when on the final hand I went all in with a pair of nine’s. I wouldn’t always recommend that strategy but that night it worked for me.

Truly for the social aspect of life here, poker nights have provided me with something to look forward to. Those folks have become good friends and I am going to miss living there. However am grateful that I can still go over and play.

A Patient Story

2010-01-22T13:53:00.001-05:00

This was the best thing I did last week. I spent about an hour in our fistula room, talking with the patients there. We have six beds for women who have been diagnosed with having a fistula (a hole between either the rectum and vagina or between the bladder and vagina). This condition can occur after severe childbirth when adequate medical care is not available. The women who have a fistula can experience a lot of social isolation and it will significantly reduce the quality of their life. It was in our fistula room that I met Gulsum. She is 25 years old and lives in a rural village about eight hours outside of Kabul.

After having her second child, she noticed that she was leaking urine. Over the next four months her husband took her to see several village doctors. One of the doctors recommended a hysterectomy and her husband approved (typically a husband or a woman’s father will give consent for surgery). Gulsum had the surgery but the problem didn’t go away. She thought she was "finished for life."

Gulsum was taken to see one more doctor. This village doctor had recently returned from spending one month training at my hospital. He saw Gulsum and explained to her about a surgery that we offer that will fix her problem. She was so excited but told him she didn’t know how she would be able to afford the surgery. Then the doctor explained that our program would cover the cost of the surgery and the cost of her transportation back and forth to the hospital.

She is recovering, the surgery seems to be a success and she should be going home soon. While her and I spoke, she was beaming. Her excitement was contagious as she explained that she was now “dry” and how "this hospital gave me life again." It's stories like this that remind me why I am here.

T.I.A.

2010-01-08T14:12:00.002-05:00

In the book Stones into Schools, Greg Mortenson describes Afghanistan as “a place where life is often messy, confusing, and unfair – and where events almost never conform to the script that has been laid.” In the four months that I have been in country, I can testify to the truth of this description. My team has coined the phrase “this is Afghanistan (TIA)” as a means to assist us in coping with the messy and confusing aspects of life here.

My most recent example has been the visa process. I arrived in September with one visa, which as it turned out was no longer the correct visa to have in order to get a work permit. The unofficial explanation for the change “TIA.” As a result several of us had to leave the country to get the correct visa. None of us minded because who doesn't mind a surprise weekend in a warmer climate. We had to leave because you cannot renew your visa in country without a work permit. The visa I was given expired in a month, which because of TIA a month isn't enough time to be issued a work permit and a new visa. So off to the consulate to get another visa. No worries, this is my 3rd visa.

But for some reason, this time did not go according to script. The only reason I have for the complicated process; TIA. After visiting two embassy’s and pleading my case to anyone who would listen, I was granted a visa; which as they say here Enshallah (God willing) this is the right one and can be renewed in country.

Sometimes a picture is worth thousand words. Thankfully it all worked out and I am back at work.

New Year’s Eve in the Desert

2010-01-08T13:44:00.004-05:00

Happy New Year!

Spent the past week in Dubai and it was great fun. Went to the beach, swam in the Arabian Gulf, shopped my heart out, and visited the aquarium. For New Years Eve, we went on a desert safari. It wasn’t everything I expected but it was fun.

The ride out to the campsite would have consisted of more dune bashing if the women in the front seat wasn’t carsick. We were told the food at the campsite was going to be a BBQ, but it was Indian, as was the music. The dance floor could have been one you would find any where in the States except it was filled with people of all ages. The air was cool and the sky was clear, it really was a nice night to be outside. We opted out on the camel ride but enjoyed getting to know the other people at our table. It sure was a memorable way to ring in 2010.

The first photo is of the beach we went to. You are not allowed to take pictures on the beach but can in the park that is attached to the beach. The second picture is of the park attached to the beach and in the distance you can see the Burj Dubai (now called the Burj Khamira; aka worlds tallest building).

A weekend away

2009-12-19T05:02:00.002-05:00

Two weeks ago four of us had to go to Dubai to straighten out some visa issues. It was a little hassle but thankfully we all seem to now have the correct visa. Hopefully the last few things that need to come together will. Worse case scenario I’ll be home sooner then planned.

It was so interesting to be in Dubai. In a lot of ways it is the polar opposite of Kabul. There is construction happening everywhere you turn. The buildings are tall and the equipment is modern. It was impressive to see all the tall buildings.

This was my first trip out of the country and I was amazed at how homesick I started to feel and for things I didn’t know I was missing. We were in a mall and I recognized the music in the background, which seemed so odd. Plus it was so exciting to be in a mall and to able to use a charge card. At one point we walked out of a well known furniture in the States and felt particularly homesick. When we looked up at the next store, it was called "I want to go home." The irony was to much.

Other items I noticed, the smell of fresh cut grass. I was surprised at how green Dubai is and it really isn’t that green but the medians have grass, which is something I haven’t seen in a long time. The hotel had a mini-gym and I was able to run, again I haven’t been able to run since I left. One of the women who traveled with me said she hasn’t seen someone so happy after going for a run. I can’t say I was as happy the next day, my legs hurt but it was so worth it.

We were able to walk around outside. I spent the first day or so feeling like I forgot something and then I realized it was my headscarf. Guess I have adjusted to wearing one. Walking down the streets you heard many different accents and a few different languages. It’s like a mini-United Nations.

Being there for a long weekend was a great respite. I am looking forward to heading there again in just over a week. It will be fun to spend New Years there and really get to explore what there is to do.

Happy Thanksgiving

2009-11-29T03:41:00.002-05:00

When I woke up on Thanksgiving, I wasn’t feeling particularly thankful. This was the third day without power, which also means no hot water and no shower. We do have a generator but only one apartment can have their water heater plugged in at time. And none of us had it plugged in since we kept expecting power to come back on any minute. The temperature reading on all four tanks was far away from any reading that resembled warmth and it would take a while for one to get warm.

We have been very fortunate and had power most days since I arrived. When we do lose it, it has only been for a few hours and at most over night. Not this time.

Since we don’t have central heat, when the power is out the electric heater in my bedroom doesn’t work. My other option for heat is the propane heater in my living room. Theoretically I could fall asleep with it on since it’s vented outside and not worry about carbon monoxide poisoning, but I’m not going to risk it. Between the lack of power, 3 days without a shower and my bones feeling cold, the homesickness hit with a hammer.

As I was lying in bed having a personal pity party and heard the rumble of the generator, my cell phone rang. Why is someone calling me at 8am? It was Rick and he wanted to see what time we could all have a pre-meeting about the project meeting we had later in the morning. All’s I was thinking was “great, a pre-meeting meeting on Thanksgiving.” I agreed to 9:30a and as we got off the phone thinking, well I was thankful for the generator but I’d rather be home.

Thankfully the day and my mood improved dramatically. Our actual meeting was at a military base and was followed by Thanksgiving dinner with the troops. As we waited in the chow line, the sun was out and the view of the snow-covered mountains was spectacular. The food inside was the biggest spread I have ever seen and had almost all the treats of home. As a bonus, they were replaying the UCONN men’s basketball game on TV.

On the ride home, we joked about how crabby all of us were in the morning and we realized how wonderfully we were provided for today, even the small ways. When we arrived at home, the electricity was on!!

Happy Thanksgiving!

A Wish

2009-11-22T11:34:00.002-05:00

I celebrated my 35th birthday this week. I think being here distracted me from focusing on the actual number. The inauguration was Thursday and I was worried that would limit our plans for the weekend. Thankfully things were quiet on Thursday and by Friday afternoon we were allowed to travel.

The celebration on Friday started with a walk to a near by restaurant. The sun was out and it felt fantastic to be able to stretch my legs. Those opportunities to get out and walk are few and far between when you live here. Being able to go for a walk was such a nice present. After lunch I came home and took a nap, another treat. For dinner the whole gang went to a restaurant that serves one of my favorites; nachos! We had a great time, laughing, eating and drinking with no or very little talk about work. I haven't laughed that hard in a very long time. We spent a lot of time comparing those "not-in-Kansas-anymore" stories. These are the real stories and if we shared them people would really wonder why we are here.

Saturday the celebration was going to continue with brunch at a fancy hotel. Except last minute we were placed on travel restriction and couldn't go. I could slowly hear the air leaking out of my birthday balloon. We rallied, ordered pizza and watched a movie. Not a bad way to celebrate but I was disappointed. In hind-sight there was some divine intervention, later on Saturday that hotel was hit by a rocket. I don't know if we would have still been there. I didn't hear how bad the damages were and I'm not sure if there were any casualties. Either way, it helped put my disappointment over my birthday plans in perspective.

Today one of my nurses, her husband died and now she is a single mom. He was admitted over the weekend and had been chronically ill for a long time. Today I made time to stop by and check in. As the day progressed I could tell he was getting worse and it wouldn't be much longer. With my very limited language skills, I really had no idea what to say. All's I had to offer was a hug.

I'm not sure what the customs are for funerals but I can tell you that grief is the same. It was heartbreaking to see the family lamenting outside the hospital as he was placed in the car. The poor son, fell to his knees and sobbed in the grass. Back home, I'd bake something and bring it to her house. Maybe even a group of us would plan how many nights to bring meals over. I wonder what people do here to show their support. I'll ask some of the staff in the morning but for now, I wish/hope she has the support she needs.

Keep Smiling?

A Pep Rally

2009-11-17T23:15:00.000-05:00

Last week was a busy week. We had a visit from Head Quarters and a team of five arrived. The team consisted of a Senior Vice President, a Board Member, the founder’s wife, a member of the development team and a radio talk show host. I wasn’t sure what to expect from the visit and had visions of it being like a giant inspection. Instead it was like a week long pep rally. It was a little chaotic and a little stressful at times but overall it was encouraging to have them out. The bonus about their visit was we went out to eat every night and I didn’t have to cook at all.

The team arrived on Sunday and that evening we had dinner and a team meeting. We made the introductions and each of us talked about how we ended up here. On Monday they arrived at the hospital, had meetings with the department heads, and were given a tour and a rough schedule was set for the week.

The hospital staff was really interested in meeting the “American Visitors.” We held a mini-all staff meeting and provided everyone an opportunity to introduce themselves and ask questions. About 25 staff attended the meeting and it was a good representation of all the departments, both clinical and non-clinical. I was a little nervous about what questions the staff might ask but overall it went really well. Staff was mostly concerned about how the current economic situation in the States will impact our funding and ability to raise support for the hospital. They asked a lot of questions about long term plans and if we were going to open more clinics around the country.

My favorite part of the week was when we took some of the graduates from our Residency program, who are now Attending’s and working at the hospital out to dinner. It was great to see the Doctors outside of work and get to know them better. The conversations were fun and light hearted. I think the visiting team and the doc’s really enjoyed themselves. I know I did.
Overall the week was great, exhausting but great.
Keep Smiling!!

Training Day

2009-11-17T22:28:00.003-05:00

Last week I had an opportunity to visit two of the villages near our out-patient clinic. The clinic is about a kilometer from the hospital. We are in the process of starting a community health worker (CHW) program. The purpose of the program is to train volunteers from the surrounding communities to be health educators for their villages. These volunteers will be our eyes and hears in the community and help us better meet the physical needs of our community. In graduate school I read a lot of articles about using CHW’s in international settings and I am so excited to be a part of rolling out this program.

We have already met several times with the village elders to explain the purpose of the program and what we expect from the CHW’s. Most of the elders seemed really excited about it and were eager to be involved. It was up to the elders to select the volunteers, based on certain criteria. The elders also provided us with some topics and programs that they thought were the biggest health needs for their villages.

The first village we went to is a Tajik village and we met with 12 women in the house of one of the women. The education we will do in this community will occur after their religious studies at the mosque. It was exciting to hear that they have already identified a time and a place that we can meet with a large group of women. During the meeting the women had a lot of questions about the H1N1 flu. An interesting question they asked was if swine flu was a real disease or just some political agenda item. I was able to explain it is a real disease and I also took the opportunity to tell them a few key ways to prevent the spread; i.e. hand washing and covering your mouth when you cough or sneeze. I felt a little silly talking about the importance of eating right and getting a good night sleep when the poverty in this village really limits what they have available to eat.

The second village we went to is a Hazara village. Here we met in the education building which is next to the mosque and we met with 8 about men. The topics they are most interested in are hypertension and respiratory illnesses (asthma and COPD). H1N1 was never mentioned. Air pollution is a huge problem here and many adults have chronic respiratory issues.

Later that afternoon the 14 trainee’s arrived for their first session. The goal was to again explain the expectations and determine how many times a week they would be able to attend class. It was exciting to me that the majority of the trainee’s are female and that one of the village elders wants to be a trainee. The part that was funny was that the only thing they seemed interested in was when they would learn how to start IV’s and give injections. We spent a lot of time explaining that we aren’t going to teach those skills, at least not yet. I don’t think I have ever seen such enthusiasm around “poking” people.
This week we have had 2 training sessions, the attendance and level of interest seems to be holding even if they can't "poke" people.
Keep Smiling!

Be careful what you wish for

2009-11-02T23:01:00.000-05:00

I confess that there was a part me, the infectious disease/infection prevention side that was slightly envious of the H1N1 (swine flu) situation back home. I felt like we had been talking about the big outbreak of bird flu for years, so what if we confused the animal, bird, pig whatever. I wanted to see how it all played out. I spent a lot of time reading about influenza, learned about how the vaccine is made, how effective it is, wrote a paper on it for school, studied how it’s transmitted, the incubation period, and tried to lay the ground work for encouraging behaviors that would prevent the spread of flu before the big outbreak hit. And finally when it hits, I’m not there.

I suspect you are reading this and thinking I’m a nut case. And foolish of me to think I wouldn’t be involved if/when it here. The difference, I felt slightly more prepared to handle it back home. I’m less sure about how things will play out here.

We had our first emergency preparedness meeting about this yesterday. The Ministry of Public Health (MOPH) announced the night before that they were closing ALL the schools in the country for the next 3 weeks. I don’t know what the absentee rate has been or even how many confirmed cases we have. I think it’s some where between 250-300. We have seen a few outpatient suspected cases. No staff has been out with influenza like symptoms. Not yet at least –thank goodness. But each day, more and more people are seen in the community wearing masks. Women are wrapping their headscarf’s around their nose and mouth. I am giving my elevator speech on hand washing but I think the next few weeks are going to be really interesting on a lot of different fronts.

Keep Smiling!!

What a week!

2009-10-29T14:40:00.002-04:00

On Friday (after the earthquake) we went to Istalif for a hike and spent the day at the Lodge. It was beautiful, the air was clean and it is so rural. After spending two months in the city it's hard to believe that there are such green and quiet parts to this country. I think our lungs appreciated the clean air as well. As we headed back into the city the “Kabul cough” returned.

The Lodge is a small camp in the mountains that is a perfect place to hike, rest and enjoy the beauty that this country has to offer. They advertise “mine free trails.” We hiked in, had lunch and spent the day exploring the mountains and the wild life around us. Some of our group saw a rattlesnake. Thankfully I was not part of that group!

The road in takes you through town and some parts of the road are very narrow. At one point we had to back up and squeeze the van next to the stonewall so another car could pass. As you get closer to the Lodge the road becomes more of a dried up river bed and it brings you about a mile away from the lodge. You have to hike the rest of the way in. By far, this was my favorite day here.

The weather is officially cold and I am still waiting for them to install my heaters. Every day I ask what's the status and I'm told "tomorrow." This morning it was 60 degrees in my apartment, not terrible but not great. I have been told that in the winter, showering is over rated but central heat is not. I am starting to understand the full meaning of that statement.

Yesterday was an interesting day here as I’m sure you saw in the news. I live far enough away from the events that I did not hear anything. But it is very strange to watch the news footage and know you've been there. I do have friends that live nearby to that and they heard every thing. Thankfully they are all safe. In pre-field training they encouraged us to find 5 joys in each day and after yesterday it's good to remember that there are at least 5 in each day. These are mine from yesterday:

1. Me and my team are safe

2. We had city power

3. I had a good Skype connection with my Mom

4. We were on the late shuttle so I was able to sleep in until 6:30a

5. Ended the day with dinner and a game of "Settlers" with friends

Keep Smiling!!

My First Earthquake....

2009-10-23T11:07:00.003-04:00

Last night I had several people over for dinner and it was a wonderful way to end a crazy week. Good pizza, good friends and good fellowship. Around 11:30pm I climbed into bed and pretty much fell right to sleep.

Some time around 12:30am, I am woken up from a sound sleep and my bed is gently shaking and the dogs are barking. In my dazed and confused state, I figured it was a big truck driving by. Then I remembered where I am and that no big trucks drive by the house. My next thought is, "oh no it must have been an explosion." Then I realize that my bed is still shaking and it's gotten worse. Along with bed, I can hear the clothes hangers banging against the closet door and the cabinets under the bathroom sink are rattling. I swear I saw the walls moving, but I was half asleep so that may not be true. It ended just as gradually as it started but it felt like it lasted for 5-10 minutes. In reality it was about 15 seconds.

Needless to say it freaked me out. I was so disorientated and wasn't really sure what had happened. Being woken up from a deep sleep is always terrible but it really stinks when its because of an earthquake. It took me a few seconds after it all ended to remember that I read something a while back that there are earthquakes here. Then a another few seconds to remember that I should have grabbed my passport and stood in the door frame.

The next 20 minutes or so were spent sending text messages to make sure the rest of the team was alright. It was over an hour before I was able to think about going back to sleep and even then I didn't sleep well. I kept thinking, "My sister Andrea lives in California and she lives through them, so chill out." But seriously, like this country doesn't have enough struggles, I now have to add earthquakes to the list?!

I learned this morning it was a 6.2 -not bad for my first one! But this was an experience I could have missed and been perfectly happy about it. Thankfully we are all ok and I didn't feel any aftershocks. Let's hope this was my last one.

Keep Smiling!

My First Wedding

2009-10-17T10:43:00.003-04:00

I attended my first wedding in this country on Monday night. The wedding was held in a wedding hall and about 700 people were invited. As we approached the hall you could hear the music playing outside. We handed our invitation to the man at the door and were ushered into the female side of the hall. Men sit on one side and women on another. There is a partition dividing the room in half and neither side can see the other.

The women's side did have a video screen that would periodically show what was happening on the men's side. There was a band, but again the partition surrounded them. The room was full with tables with plastic flowers as center pieces. As we walked in, we were ushered to a front table near the dance floor. On the other side of the dance floor was the "head" table. The head table is raised off the floor, the wall behind them was decorated with white linen, white plastic flowers, a green sash and white and green small lights. The lights looked like Christmas lights. The atmosphere was very festive and happy.

The tables surrounded the dance floor and one by one women got up and danced. Generally the women would dance in groups of 2, sometimes 3. They would be on the dance floor for a few minutes and then give another group a chance. The dancing was beautiful and graceful. Yes, I did dance. I didn't have much of a choice, my coworker pretty much dragged me to the dance floor. Thankfully it was only for a few minutes because my dancing skills are no better here then they are at home. I felt very silly but everyone was very kind and supportive as I gave it my best.

The women don't have to cover their heads since no men are present. Everyone gets very dressed up, there were lots of bright colors and lots of sequence. Some women wore gowns and others, like me wore a Punjabi. The wedding started at 5pm but we were told to come around 6-6:30p. Around 7:30p the bride and groom entered the room.

They roll out a white carpet. The bride is wearing a dark green dress and carrying red flowers. Her hair was pulled up and she had some flowers in her hair. Her lipstick had glitter in and it looked like some was in her hair. The groom wore a white suit and a green tie. They both looked sharp. They walked in and sat at the head table. For the next hour or so, different guests would have their picture taken with the bride and groom.

There are two parts to the wedding. The first part is called the "neka" and the bride wears green and she wears white for the wedding. If I understand it correctly, neka is agreement of marriage. The part of the wedding I observed was the neka stage. I think while we were eating, the groom meets with the mullah and the marriage is made official when he signs the marriage contract/certificate. The bride is not present for this part, I think this is when she changes into her white gown. We had to leave right after we ate, so I never saw the bride in her white gown. A few days after the wedding, the guests will bring gifts to the newlyweds house.

Around 9pm the food was served. It was a sit down dinner. One dish called kabuli pilau, which is rice, shaved carrots, raisins and meat was really good. This is very traditional dish. We also had ashak which is a leek filled pasta with meat sauce. That reminded me of a pirogi. I didn't enjoy this as much as the kabuli pilau. Other food dishes were served, one with eggplant and another chicken dish but I don't remember what they were called. They served coke to drink or orange soda. There was also grapes and bananas available.

I wasn't able to stay until the end. But it was a lot of fun and if you ever have the opportunity to go, I highly recommend it.

Keep Smiling

The Fabric Bazaar

2009-10-06T13:26:00.004-04:00

I was invited to my first Afghan wedding and needed an outfit to wear. A coworker took me to a fabric bazaar to select fabric for a Punjabi.

The fabric bazaar is a long path of shipping containers lined up next to each other and each had a fairly large selection of fabrics. They ranged from cotton to silk. There wasn't a lot of room between the containers and thankfully the bazaar wasn't crowded because I felt like we were walking on top of each other.

The last time I picked fabric for an outfit I was in 6th grade and was going to be a junior bridesmaid at a wedding. I don't think I had much say in picking the fabric or what the final outfit would look like. This was harder then I expected. I struggled with looking at the fabric and visualizing how the outfit would look. Plus the choices of fabric were overwhelming.

It was handy that the fabric was packaged to include pants, top and chadar (head scarf). I tend to avoid wearing tops with a lot of patterns, which I was told was not the trend at weddings. Most women will wear bright colors, patterns, gold and/or sequence. It was a huge help to have my coworker with me. In the end, we found something both of us could live with. She was so cute as she tried to guide me towards fabrics that had more "bling" then the ones I was drawn to. I selected a purple and maroon fabric with a silver pattern in it.

Once we selected the fabric, which cost $10 it was off to the tailor. In the tailor's shop there was a book that was filled with the different styles of punjabi's. I was so excited that there was a book because I wasn't really sure what a punjabi looked like until this point. A punjabi is a type of pant suit; shirt has short sleeves but is long and comes to mid thighs. The pants are elastic waist and loose fitting. Punjabi's are very comfortable to wear, it reminded me of wearing scrubs. To have the outfit made it cost $5. Not bad to have an outfit for a wedding that cost $15.

I think this is the way to go, select fabric and have someone make the clothes for you. It's so much easier then going to the mall and trying on a hundred different things. Its also a lot less frustrating because in the end the outfit fit.

Keep Smiling.

An end to the mouse drama?

2009-09-27T08:54:00.005-04:00

Last week the mouse in the office was successful in stealing the bread we left in the trap. On Thursday afternoon I was meeting with a few nurses in the office when we all heard a loud snap and then this high pitched squealing. Within a few seconds there was a banging sound that came from inside the cabinet and three very confused nurses in the office. After some coaxing, one of the nurses opened the cabinet to find the mouse trap up against the back of the cabinet, no mouse and no bread. And so we reset the trap and figured/hoped, maybe we injured the mouse.

Today, we had success. We checked the trap and this time our mouse wasn't so lucky. After a quick call to housekeeping the mouse was taken out to his burial grounds. The head of facilities has explained to me that this will not be the last time we have a mouse in the nurses office. But for now, I feel like it's nurses 1, mouse 0.

One of my sisters asked if she should include some mouse traps in a care package to me, I don't think we have reached that point... yet. But I am open to suggestions for how to keep them outside of the hospital, especially the nurses office =)

Happy Eid!!

2009-09-23T14:30:00.002-04:00

Eid Mubarak! Yesterday marked the end of Eid, which is the 3 day holiday celebrating the end of Ramadan. This holiday is celebrated by going to visit friends and family, eating and drinking tea. Children get gifts of toys and adults will get new clothes. The first day most of the visits are between family and the next two days are devoted to friends. There are lots of people out and about and many shops are closed. We were invited to two different homes on the last day of Eid; one from a current employee and the second from a former employee. It was really fun day.

Usually the men and women eat in separate rooms. I'm told this happens at weddings as well. I was invited to my first wedding and will be able to describe that in a few weeks. I'm not sure why they broke this custom but it might have been because we were the honored guests. In the second house, after we ate Jackie and I were taken into the other room where the wives of the men were. They were so sweet and between our limited Dari and their limited English it turned in to a very pleasant afternoon. One of the cousins was able to translate, she teaches english classes.

We all sat on the floor on these large cushions called toe-shacks (phonetic spelling). A table cloth is spread out on the floor and the "table" is set. Most of the food served is cookies, candy and various nuts. Since we were at one place during lunch they also served chicken and yogurt.

The conversations ranged from politics, work and various topics. Everyone was so hospitable and let us ask questions about how they celebrate Eid and what's it like to fast for a month. Ramadan is never the same time each year, and what I imagine as the hardest part is not being able to drink during the day when Ramadan falls during the summer months. Our hosts were equally as interested in our holidays and how many days we get off from work during those holidays. Most of their questions were about which American holiday was similar to Eid. We compared various aspects to Christmas and Thanksgiving, in some ways Easter.

The two holidays they were most interested in learning about were Valentine's day and April Fools. They loved that we have a holiday that allows people to play tricks on one another. Of all the holidays to pick, that's what they had the most questions about. It was really hard to explain that those aren't "real" holidays, that concept doesn't translate well. It's fascinating to hear and learn what people know about America.

Keep Smiling!

Eating for fuel

2009-09-21T07:41:00.005-04:00

Eating has become more about fuel and less about pleasure. I broke down and have decided to support the local economy and hired a women to cook for me. She will cook two nights a week and the meals will be a combination of local dishes and some western dishes. She has lots of experience cooking for westerners and the meals are well balanced and much nicer then anything I have been cooking for myself.

Last week was the first week she cooked for me and it was heavenly. Typically I've been having a sandwich, soup or some version of breakfast food for dinner. Eggs for dinner have become a favorite since lunch is typically carb-overload and I feel like I'm developing a protein deficiency.

Cooking here isn't like back home, it's so much more involved. I have a gas oven and you have to use a thermometer to tell how warm the oven is. I have no idea how to cook this way. I did learn how to light it and used it last night to warm up a beef patty I bought at the french bakery. Maybe this weekend I'll take on the challenge of cooking chicken or something? Assuming I can get one that someone else kills, cleans and cuts it up in to pieces that look like something you'd find in a western grocery store. Lol, I'm not ready for learning those skills just yet.

Lunch is provided by the hospital. Everyone eats the same thing, there aren't options. It costs $9 a month to feed each employee at the hospital. There is always rice and usually enough on your plate to feed a small village. I have mastered the hand gestures to convey to the food service staff "half of that, please." The main food item has been one of these; beans, okra, small pieces of beef tips or some lentil chickpea mixture. There is always some piece of fruit, mostly melon this time of year. Then a piece of nan (bread) and for beverages its hot tea or water.

We have gone out to eat twice since I have arrived. One night we went to a BBQ place. I'm not a huge red meat eater and during grad school I had really reduced my meat intake. But I saw steak on the menu and couldn't resist, again I think its a protein thing. It was 12oz rib-eye and absolutely so good. As an appetizer we ordered nachos. They aren't the same as back home but they work. I attached a photo of them since words can't really describe what they look like here.

The second place we went out to was a government party. The organization that hosted the evening is here training the national lawyers in how our legal system works with the goal of improving the legal system here. They have training centers in several of the providences and their work sounds fascinating. Every other week they have a dinner and we were invited to attend. The food, amazing - hamburgers and shrimp on the grill. I have to figure out how to get invited regularly. Rumor has it that sometimes they even have ice-cream!

Twice we have ordered take-out. Once was from Pizza Brazil and the second place was Indian food. The pizza was thin crust and not bad. Again similar to home but not really the same. Indian food was pretty good and generally that isn't something I tend to eat.

There is the French Bakery and in addition to beef patties they have some great desserts. Sometimes on the way home from work we can stop there. Its a cute little place and they have different types of bread, cookies and donuts. They also sell eggs, yogurt and milk. I believe the owners of this place train nationals how to cook the food items that are sold in the bakery.

I think until I get a better handle on the language, cooking will be a challenge. Fruit and vegetables are sold in the smaller roadside stands, English isn't their strength and Dari isn't mine. Last night a few of us walked to a stand around the corner from our apartment and I was able to get bananas. Between not understanding the language and how to order the fruit in kilograms, its stressful. Everything is weighed in kilograms and I know 1kg = 2.2 lbs but how does that translate into paying for 3 bananas? Also depending on when you get to these stands, the quality of the fruit and veggies varies.

We make it work and no worries I'm not starving. Plus I'll start language lesson next month which will be so helpful.

Keep Smiling!

Transitions

2009-09-18T06:15:00.002-04:00

I was recently asked what the biggest transition or adjustment is. After some thought, I told them there isn't one big thing, its that everything is different. Nothing is the same and its the lack of consistency of the small things that are the most draining. I miss those creature comforts; mostly consistent Internet, water pressure in the shower and paved roads. I miss family and friends too but having Internet is what keeps me connected and possibly sane =)

I am very thankful to have Internet, I don't know how people lived out these type of adventures without it. I am trying to adjust to the fact that it doesn't always work when you want it to.

Another adjustment is security. There was an incident yesterday on the other side of the city and as a result we are restricted as to where we can go. Thankfully no one we know was hurt. I don't envy our security director, he has to make some tough decisions. I am bummed because on Fridays we go grocery shopping and all the grocery stores are on the other side of town. I won't starve but I really look forward to these outings. I know its pathetic to be disappointed that you can't go grocery shopping but getting out during the week is unusual.

There are a variety of reasons why we don't/can't do these things after work. One is the stores are on the other side of town and traffic is terrible during the work week (Sun - Thurs). Traffic here is unlike anything I have experienced, it makes Chicago or LA traffic look like smooth sailing. Cars, bikes, motorcycles, goats, people walking, donkey pulled carts and then the unpaved bumpy roads, makes for an interesting commute.

I'm not complaining about the security restrictions. I prefer that our security director be on the conservative side of things. Its just another transition learning that your schedule isn't really your own. I am just hoping that while we are off for the holiday these next few days, that some stability will return to the area and we can go across town. 4 days in the house will make me a little stir crazy and lonely.

This morning as I was getting ready, I heard what I thought was a child moaning outside. I thought someone was hurt and rushed to the window to see what was going on. I was surprised to see a herd of goats walking down the road. I had to laugh. Guess this is just another transition.

Keep Smiling!

Compassion or Policy?

2009-09-15T13:03:00.003-04:00

I have been very thankful, the last two days at work have been good ones. I'm learning a few more names and am getting lost a less. The hospital is a large square so if you go the wrong direction, eventually you end up where you wanted to be. Since I haven't been able to run, I don't mind the extra steps. I have taken to jumping rope on our roof in the evenings for some exercise. Tonight I was a little desperate and did suicide drills. I quickly remembered why I hated them during basketball practice. The roof isn't large probably comparable to half a basketball court, at least the part we can use.

Today was a long day, there were a lot of little human resource (HR) issues to deal with. Most of them minor things. My day started with an inservice in one department to discuss professional behavior and the importance of treating our patients and other members of the healthcare team respectfully. There were two complaints last week in this department that we used as "case studies" to see how they could have been handled differently.

However there was one HR issue in particular that I can't shake. I am struggling with balancing compassion and adhering to policy. As a nurse, as a women, as a public health professional I want to help this staff member. They have valid points but as a Director if I make allowances this time, don't I have to do the same for everyone else? As a leader, I know I can't make an allowance for them. We met as a leadership team to discuss this event so I know I have the necessary support but it will break my heart tomorrow to tell them I can't allow them to do what they want. Things are complicated and everything isn't black or white. The scenarios are unique and the challenges that are hard to describe. But we make a decision based on the information we have at the time and let's hope its for the best.

On a very different note, its raining here. We are actually having a thunderstorm. Who knew.

Keep Smiling

Grocery Shopping and Laundry

2009-09-12T05:21:00.002-04:00

I am experienced at grocery shopping, have been doing it for years but not like this. There are a few stores that we visited to accomplish getting food. The first, is similar to a western grocery store its clean and has an array of items. It's not very large and some of the prices are higher then the other stores we visted. I didn't mind because it was clean and well organized. They even have grocery carts, but they are much smaller then the ones at home.

I was pleasantly surprised with the options available but was told this isn't where we buy fruits and vegetables. I bought canned tuna, canned soup, whole wheat pasta and sauce. All things I can make using the top of the stove, I haven't figured out how to light the gas oven yet.

The next store we went to was much more dusty and not as organized. The interesting thing at this store is the prices are negotiable. They also had food and household items. I bought a throw rug and paid $15. Not because I was good at negotiating the price, I didn't even think to ask if there was a "discount." One of the girls I was shopping with asked because she was also buying a rug. They aren't fancy but I needed something to put in the hallway. I am anxious to go to Chicken Street where we can get some hand woven Indian rugs. We haven't been allowed there on account of security restrictions.

The last place we went to was an open market known as the Obama Bazaar (last summer it was called the Bush Bazaar). This was unlike anything I have ever experienced. There are rows of shipping containers that have been transformed into little stores. If you are patient, you can find just about anything here. Knowing the language and being a good negotiator are key skills to posses in the bazaar. It's also important to check expiration dates since not everything is "new." I did get a t-shirt for $4. As we walked in to the area, freshly slain animals were hanging. I haven't had much meat since I arrived for two reasons. One, I haven't figured out how to light my oven and two, I can't bring myself to buy the meat. The second grocery store had frozen chicken which I'll get once I figure out the oven.

Fruits and veggies we bought at a roadside stand. The mango's are amazing. I didn't get any veggies and in hind sight should have. Either way the fruit and veggies need to be cleaned before you can eat them. This involves rinsing the dust/dirt off with regular tap water then soaking them in this bleach solution for 20 minutes. Once that is done they need to air dry on a clean dish towel. We can't drink the tap water but thankfully I have one of those water-coolers in my apartment.

Doing laundry also involves a learning curve. I had to have one of my apartment mates show me how, it's a bit humbling. I really don't know how to do anything on my own anymore. The machine is small, it resembles western machines but not really. It front loads and has a lot of buttons. One for selecting the actual temperature not just cold, warm or hot. One to select the speed at which you want the machine to spin, again an actual number and one for the type of cycle. That was the only button that was familiar to me. There were other buttons but they seemed a little high tech for my needs today. A wash cycle lasts an hour and a half.

I am very thankful to have a washing machine and it seems to do a decent job. There is no drier so after washing clothes, you have to carry them up to the roof (4 flights) to line dry. The roof is actually our patio. I'm not sure how it works in the winter. I suspect clothes dry in our apartments and I'll have to add drying rack to the list of things to get. I also need a laundry basket, thankfully an apartment mate let me use his. Community living does have its perks because I'd be lost with the help.

Everyone keeps asking if I brought warm clothes for winter. I think so? I'm getting the feeling that the winter will bring a whole new set of learning curves and adventures.

Keep Smiling!

Not in Kansas anymore

2009-09-08T12:06:00.002-04:00

Not that I have ever been to Kansas but that expression pretty much sums up my first week. Our work week is Sunday - Thursday.

My first official day as Director I got in trouble with security. Very innocently I had left my camera in my bag and when the guard was checking my bag before I was allowed in the building, she confiscated it. I tried to explain that I was the new director of nursing and to call the head of security but I don't speak Dari and her English isn't great. So I accepted the id card and headed into the hospital for orientation. Thankfully the first person I met with was head of security. He was glad that I took the opportunity to test our security procedures. I appreciated his grace and that he was able to retrieve my camera.

After my security orientation I was taken to my new office to meet some of the supervisors. As I was being introduced a mouse ran across the office. I was a little startled and said to the two supervisors; "Um, oh, oh um was that I mouse?" I was trying not to have my first interaction with them be one of panic. They both smiled and said "probably." They must be pretty used to foreigners flipping out. No worries we don't have mice running around the hospital on a regular basis but it's not unheard of to see one every now and then. I appreciate that this one wanted to welcome me and that he wasn't in my apartment.

The rest of the week has consisted of meeting various department heads and learning how our departments interact. It's budget time and we had a very interesting meeting today to discuss salaries and performance evaluations. The average nurse here earns between $180-$300 a month. Night staff work longer hours then day staff because they need to be at work before it gets dark. There is very limited public transportation at night.

The nursing department consists of 104 people; 60 nurses (mostly male), 24 midwives (all women) and 20 patient aids. We are hiring nurses if anyone is interested =)

I am very thankful that we have had steady city power in the evenings all week, my shower drain is unclogged and that each day I learn something new. I am looking forward when I'm not learning so many new things but till then....

Keep Smiling

First few days

2009-09-04T14:07:00.002-04:00

I arrived in country early Wed morning. It seems for this trip all of my flights required leaving for the airport at 4am. That's not really my finest hour.

Leaving for Boston on Sunday morning was so hard, not only because of the hour but because I really had to say good-bye. Michele and Betsey were taking me to the airport not my parents, which worked out well. They are great friends.

On Wed, I had grabbed a banana at the guest house before we left, hoping to get a bite to eat at the airport. I remembered from last summer that there was a small coffee stand inside the gate. I was so surprised to see that they had made some renovation's which included expanding the coffee shop, adding a McDonalds and a new smoothie stand. I figured may as well have the McDonalds. In an odd way it seemed fitting to eat McDonalds, especially since I hardly even have it in the States. It was so funny because they didn't have breakfast stuff; I opted for a cheeseburger, fries and a coffee.

When I arrived in country, the terminal had also been renovated. After customs and passport control, you have to complete a visitor registration card. I'm not clear as to the purpose of this card but it's something else to carry with you. Basically its another photo id card.

I had no idea how I was going to manage all my bags when I arrived. I don't think they had those baggage carts in the airport the last time I was there. While I was filling out the visitor card information, the porters put all my bags on the cart and brought it out to my ride. I didn't even ask them! The expected fee for this is one-dollar a bag. It was totally worth it, I had 3 very heavy large bags, a small roller and a backpack . It's a long walk from the arrival terminal to the parking area.

I arrived, dropped my stuff of at my new apartment got a quick tour and then went to the hospital. I had lunch there and spent most of the day with the Executive Director. She arrived a month ago. We chatted for a few hours and at 2:30p went back home to nap before dinner.

I'll have to save another entry to talk about the amount of dust here. I like to have the window's open in the evening because there is a cool breeze but the downside is the dust that blows in. It is unbelievable how dusty it is. Even with the windows closed it manages to find its way in. I have never washed my hands as much as I have here these last few days.

Jody has assured me that you can keep things clean but let me just say that you have not seen dust/dirt until you have visited here.

Getting my visa

2009-09-04T13:29:00.003-04:00

Getting my 6-month multi entry visa was an interesting experience. Being in a new country, even if it is pretty modern and not really understanding how the process worked and having to do it alone just wasn't something I was excited to do. I knew I could do it, I just didn't want to do it alone. But as it turned out, I didn't have to. While staying at the guest house, I met another guy (Brian) who needed to get one as well. There were several other people in the guest house who had gotten their visa's the day before, so they explained how it worked.

We had to bring a map with us because the majority of taxi drivers aren't familiar with where the embassy is. We needed a second map for on the way home so we could tell the taxi driver how to get to the guest house.

When you walk in the gate, the first building you enter looks like a shed. Inside you pay a small fee so the man behind the counter can organize your paper work and staple a passport size photo in the proper spot. Then he gives you a number and sends you back out the way you came to another room. This room has a bunch of chairs and to the left of the entrance is the processing center. The processing center is behind a sliding glass window, it looks a lot like a drive-up bank teller.

Here the man behind the counter tried to talk me into getting a 3-month visa instead of a 6-month visa. I guess everything is negotiable? After several times of telling him "no, I need a 6-month visa," he finally relented. I paid my money and then he explained there was an additional small fee for paying in US currency. I didn't have the correct change and so he "waived" it. I'm not really convinced this fee was required but either way I was thankful he waived it. After he took all my paper work, he told be to come back at 1pm. It was 9:45am. Since they are celebrating Ramadan, the office was closing at 2pm.

We had been advised not to leave incase the office decided to close earlier. My flight left the next day and I didn't want to mess up my first assignment. Without my visa I would not be allowed to enter the country. A lot of people were waiting, there had to be about 50 people in the waiting room. At 12:30p we noticed other people who had paid before us had gone up to the window, got their passport back and their visa. They never called names or anything, people just went back up to the window. In hind sight, we probably could have gone up earlier but .

The oddest part was what people did while they waited. I brought a book, which prior to this I thought was pretty much what people did. Well, some people brought their nail clippers and clipped their toes. I can honestly say I never thought to give myself a pedicure while waiting for something.

Keep Smiling!!

Last Week Home

2009-08-24T13:35:00.002-04:00

This time next week, I will be on my way. I am scheduled to arrive Sept 2 and as of today that is still the plan. The circumstances are fluid so I am preparing that my actual arrival might be delayed. More then likely I will still leave on the 30th but may be stuck overseas at a hotel for a few days before I can complete the last leg of the trip.

It is so good to be home. The training was well worth it. I feel much better equipped and prepared for things. I know it won't be an easy or a short transition but I think/hope knowing that helps. They say the average length of time it takes to adjust to a transition like this is 18 months. I find that amusing since my contract is for 24 months.

We spent a lot of time learning about transitioning and all the different aspects of our lives that are in transition. One of biggest challenges will be feeling like you don't fit in anywhere, specifically not feeling at home in the new culture but not really fitting in your old culture either. I think I feel aspects of that already, especially when I talk about the training. The people and the topics we studied really had an impact. Have you ever tried to tell someone a story and they understand what you said but they don't get the impact? I think a lot of the next two years will be like that for me. Some people will understand the impact and I'll need to be patient with those that don't.

Saying good-bye was another topic in the training. I didn't realize how much I struggle with saying good-bye until this experience. Saying good-bye is hard when you have loved well and been loved well. Which I have. The idea is to think of goodbyes as a celebration of that love. You need to say goodbye and allow yourself to grieve and mourn the loss/change in the relationship. Focus on enjoying each day and celebrating the time you had together. This week, the plan is to do a lot of that with my family.

My sister from CA arrives Thursday morning. My brother took this weekend off from work. I am looking forward to spending some quality time with the family. The plans are to get pedicures (not my bro), eat a ton of sushi and all my favorites and spend as much time outdoors as possible. Maybe do some more kayaking? Oh and I'll have to finish packing.....where is that packing easy button?
Keep Smiling!

MacGyver Training; the simulation

2009-08-13T18:34:00.003-04:00

In case any of you will be taking this training I cannot go into much detail about the simulation we experienced yesterday. Essentially experienced a scenario that unfortunately is a possibility in the country I am going to. The group was divided in half, married couples were separated and 21 of us were herded together (Bill C. was unavailable). I think the whole ordeal lasted an hour maybe an hour and a half, but it was extremely intense. I cannot begin to describe who real it felt. It put all the emergency preparedness drills I've been involved with to shame.

We knew we were going to experience a simulation and that it was going to test how we responded to stress. It is such a relief to know that I remained calm, was alert and able to process information and make decisions quickly. Not everyone in the group responded that way, some people really shut down. I found myself making a mental check list to make sure everything was getting addressed. Things I thought about were; was someone checking in on the others, who was our leader, did we have any supplies, what information did we know, how many people were outside, etc. During this whole time I never once thought about my family. I know that sounds horrible but I couldn't go there, it would have made the situation worse.

One leader never surfaced and in hind sight, that might have hurt us. I did ask who was the leader, but didn't push it. Maybe I should have? There were about 2-3 men at different points who took the lead and made decisions. I felt like they listened to my input and I wasn't offended by their desire to protect the women. I wonder if we could have done things differently, what would have happened if we did this or that. The purpose wasn't to show us what the right outcome was but to evaluate our response. A few key take home points; we made decisions based on the information we had available to us at the time and maybe in scenarios like this, there is no right decision. The purpose was look at how we responded to stress and work on those skills, not the decisions we made. And most importantly, this wasn't real. After our debriefing yesterday we had the rest of the day off.

Our evening was much more relaxing. We did a little shopping, watched a chick flick, ate snacks and laughed. It was the perfect ending to a very stressful day.

MacGyver Training; one week down two to go

2009-08-11T19:01:00.003-04:00

This training/orientation has been intense. We are in class from 8:45am to about 4pm and all this self reflection is mentally and emotionally exhausting. Thankfully the facilitators are fantastic and this is by far the best training I have ever attended.

The first week we talked about building community, value awareness, cultural differences and conflict management. We ended the week discussing how our conflict management style varies with stress. The facilitator kept saying that if you aren't willing to grow in how you manage conflict then you shouldn't be doing a job like this. I can see why, it's so important to understand how to manage conflict and how your style changes with stress. Especially when in 3 weeks my whole life will be a state of change (stress) and it's going to take a long time to adapt.

This week we are talking about adversity, stress and managing stress. They had us use the Holmes and Rahe Stress scale. The results are based on the number of times in the past 12 months you have experienced these 43 life events. The events include a wide array of items ranging from death of a family member to school starting/ending. Needless to say the majority of the group, myself included scored above a 300. This equals a life crisis stage of severe and indicates that the probability of us experiencing a deterioration in our health is 79%. The type of deterioration in health depends on how well we manage stress. Lets hope that I fall into the 21% that won't experience a health deterioration.

After the first week, I was so thankful that our weekend was free. On Saturday, I went with a couple and their 3 boys to Pike's Peak. It was amazing!! We drove, we didn't hike up to an elevation of 14,110 feet. The temperature on the top was 48 degrees, at the bottom it was 84 degrees that day. There was still small patches of snow and we had a small now ball fight. I can say with a high level of confidence that I have never had a snow ball fight in August before. I attached a photo of the view from the top but it hardly demonstrates how beautiful it is.

As informative as this training is, I'm reaching my limit of self evaluation. I apologize to those of you I have called. Please forgive me for encouraging you to reflect and evaluate what's important in your life. The end of this week the topics get "lighter" and we should be able to chat about such exciting things as how the Yankee's swept the Red Sox =)

Keep Smiling,

Jen

Arrived at Training

2009-08-03T22:50:00.002-04:00

Just a quick note to say that I arrived at my training. This place is beautiful; the mountains are spectacular and the view is breathtaking. As part of our orientation this evening they did a section on preventing the spread of germs since we are all living in such close quarters and that pleased my heart. We were cautioned that black bears have been spotted in the area but no rattle snakes.

We are in a conference center at the base of the mountains. Every thing we need is located here, including a work out room. There are mountain trails for hiking, biking and running just out the back door. There are about 42 people here plus 14 children and we are going to 19 different countries. I am so excited, I met 2 other girls who are going to the same city I will be in. One is a nurse (Ashley) and the other is community developer (Jody). Jody is traveling the same time I will be. I am staying an extra day at the B&B so we won't actually arrive in country together. This has been so awesome and I haven't even been here a full day. The training will be intense, the days look long but I think it will be fantastic. It's times like this that confirm I made the right decision. I'll have to remember these memories to carry me through when things get tough.

Support Letter

2009-07-17T16:15:00.002-04:00

Why Afghanistan?

As I debated my decision to spend two years in Afghanistan, these statistics pulled on the strings of my heart. Afghanistan is the least developed country in the world. 70% of the population lives in extreme poverty. According to the World Health Organization (WHO), the probability of dying between birth and 1 year’s old in Afghanistan is 165 per 1,000 births. While in the United States its 6 per 1,000. In Afghanistan 1 out of 5 women die from pregnancy related complications. Things shouldn’t be like that.

I want to help and feel called to go. I have traveled with Cure before and what I find appealing about this organization is that Cure International transforms the lives of children and their families through medical and spiritual healing. I believe they work at treating the whole person, not just the physical ailments. They have established specialty teaching hospitals in ten different countries. With ten hospitals, why did I choose this one? This hospital is unique because the emphasis is on treating both the women and children of Afghanistan.

Cure Afghanistan is a 100-bed teaching hospital, which includes a Neonatal Intensive Care Unit (NICU) and a bustling Family Health Center. Cure has worked hard to establish a General Practice Residency Program, an OB/GYN Fellowship training program and OB/GYN training for nurses and midwives. Cure Kabul has treated more than 120,000 patients since opening in early 2005.

What will I be doing at the hospital?

During my two-year stay in Kabul, I am going to be the Director of Nursing at the hospital. I will be responsible for planning, directing and evaluating the activities for the nursing and midwifery departments. There are currently over 90 employees in these two departments. I will be one of many new leaders starting this summer.

I would be grateful if you keep me in your thoughts as I prepare to go and while I am in Afghanistan. As this new team of leaders arrives at the hospital I'm asking that we will encourage and build up one another. May our ministry to the staff and our patients be meaningful and have transformative results.

Another way you can help is to make a financial contribution. I have a fundraising goal to raise $24,000. All donations are tax deductible. Any gift amount would be greatly appreciated.

Donation Instructions;

Visit www.helpcurenow.org

1. Get involved

2. Give

3. Support Cure Staff – scroll down to my name and picture

4. Select “give now” or “give monthly”

5. Under “donor designations” please select my name.

Thank You!!

Homeless, well sort of.

2009-07-17T15:31:00.003-04:00

It's official, I sold my house!! The closing was today, although I signed the papers last night because I didn't want to be at the closing. Now it's off to Banana Republic to spend the money. LOL, just kidding. I'm now living back at home with my parents. It's only for two weeks and it will be nice to spend time with the family before I leave for Colorado Springs on Aug 3.

I have been blessed with a great family and amazing friends. A huge "Thank you" to all who have helped me pack up and move!! I am learning this whole process is more emotional then I expected. I have so appreciated all the words of encouragement from so many of my friends. I am feeling a little needy right now and having you all to listen, encourage and/or distract me has been wonderful.

I'm not having second thoughts but this is hard. I'm so caught up in the details, I have forgotten how excited I was about this opportunity. There is still a lot to do in the next 2 weeks and little by little it will get done. The first thing I need to finish is my presentation for the fund raising event. If you are interested in supporting me, please see the post titled "support letter" it also explains a little more about why I decided to do this.

I went for a run today and despite the humidity it felt awesome. Its been a few days (well 4), since I've been able to run. Between the move and thunderstorms getting outside has been tough. I typically run with headphones and will listen to an array of music. My music taste is a little schizophrenic but today this song took my mind off of the run. It's from the musical "Rent" and it asks "how do you measure a year". I couldn't help but wonder next year, when I'm back for a visit; how will I measure a year? How different will I be, how much will have changed here and a little less philosophical will I still be running?

I was told to bring modest work out clothes, which I thought shorts and t-shirts. Thankfully I asked and was told capri work-out pants are better. I can only wear shorts if no Afghan men are present. And no I won't be running through the streets any more. The apartment I'll be in has some exercise equipment and there are always the stairs. I'm sure I'll find more spots once I'm there.
Keep Smiling,
Jen

Last week at Connecticut Children's Medical Center

2009-06-28T12:50:00.003-04:00

This is my last week at Children's. It's an odd feeling. On one hand I am ready to be done working, I have so many odds and ends to finish up in the next few weeks that work is just getting in the way. On the other hand, I have worked there an awfully long time and its familiar and comfortable. I know the players, the culture and what's expected. I think about starting over in a new place with a truly different culture, housing situation, job, and essentially nothing familiar. I'm excited and nervous.

I can't believe I've worked at Children's almost 13 years (12 years, 10 mons). I started there with one year experience as a staff nurse. I know this may sound cheesy but I feel like I grew up there. The circumstances at the hospital weren't to different from what they are now. I had just completed orientation, when it was announced we were having financial difficulties. They were closing a med-surg unit and there would be house-wide reorganization. The staff from the unit they closed was going to be divided up between the other two med/surg floors. I had almost learned the names of staff I was working with and now a whole new group of people were coming. Thankfully things aren't that precarious but times are still tough.

It was a hard time for everyone, lots of change in leadership and structure. It was good to experience those situations as a staff nurse and now as a Director. The ironic part, when I arrive at Cure I'll be the new leadership. I'm the last "change" to arrive. The entire leadership team, expect for one (chief of surgery) will be new. Change happens more frequently in Afghanistan, but it's still hard.

I'm reading a book on building teams. Jamie S. gave it to me a while ago. The title, "Becoming a Healthy Team, 5 traits of vital leadership" by Stephen A. Macchia. The 5 essential traits are trust, empower, assimilate, manage and serve. An interesting point was the discussion how many of our analogies about teams have to do with sporting events which is about competition. And being on a team should be about encouraging one another to do their best not compete with each other. If everyone isn't working towards the same mission and is more concerned about individual success then the team won't succeed long term. Hopefully I'll pick up some tips that I can implement into my future adventures.

For now, I need to get back to packing. How does one person acquire so much stuff? I challenge you to walk around your house and think about what you would take with you for two years and all's you have is 2 suitcases and a carry-on. Ok, it helps to know that your new housing situation will be furnished. How do you decide what gets to come?

Keep Smiling,

Jen

Hurry up and wait

2009-06-21T22:31:00.003-04:00

I accepted an offer on my house!! It was on the market about 3 weeks and the offer was what I was hoping for. This is such answered prayer and a big piece in the puzzle that needed to come together before I leave. The home inspection was Wednesday. Now the waiting begins, they have 14 days to get back to me about any concerns.

Honestly the whole buying/selling experience is unnerving. I'm glad to only be selling, but the home inspection was strange. The buyer didn't come; it was his agent and the inspector. I don't understand why the buyer didn't come. I'd want to be there when they were inspecting the house I was buying. The troubling thing for me was when I got home that night, it was clear someone had been through my house. All the blinds were wide open, my shower curtain was pushed to one side and the clothes in my closet were pushed aside as well (the shut-off valve for the water for the upstairs bathroom is in the closet). I felt violated, it's strange to know someone was "inspecting" my house. For now, I wait and see if my house passed inspection.

Key dates of interest:

July 3 - last day of work

July 17 - closing

Aug 3 - leave for training in Colorado Springs

Aug 21 - back home

Aug 30 -fly out to London, Dubai and then Kabul

Keep Smiling,

Jen

The first of many new experiences

2009-06-09T21:35:00.003-04:00

Friday night was my mom's retirement party. It was fun and I'm proud of my mom. This might be the first time we (her kids) were able to share in celebrating an accomplishment for our mom. She's been there to witness our graduations, award ceremonies and other events like this. It was special to be there to support her.

I'm glad however that she was not around to witness my weekend, LOL.

Early Saturday morning I was off to Chicago. Jeff picked me up at the airport and then it was off to Indiana for my first bachelor party. Please note, I booked the flight before the party was scheduled. The bachelor party was a demolition derby.

Andrew's father let us take over a field on his farm to race the cars. We had 3 cars about $150 each. One race consisted of 10 laps around the mini race course (corn field) and after 10 laps, first one done or last one standing won. Everyone was careful, honest! There were about 11 guys and me. In between races the guys would make various repairs to the cars so the next bracket could race. I laughed so hard on Saturday, probably a mix of excitement and screaming.

The guys asked if my friends would believe that I participated in an event like this. I think after announcing my career move I doubt I can shock them. I raced twice and did much better the second time. It was so much fun! I did chicken out on driving the cars over the jump, being passenger was enough. All the guys were great and who knows maybe these new driving skills will come in handy. This was by far the best bachelor party I have ever attended and maybe the next bachelorette party I plan, I'll see if Gramp's will let us use his yard again.

Sunday after church we headed back to Chicago. Spent Monday sightseeing, shopping and walking along Navy Pier. I had a wonderful weekend. Saying good-bye was hard, I was reminded of that Peter, Paul and Mary song, "leaving on a jet plane." Unfortunately this probably won't be the last time I'll shed a few tears at the airport.

The Transition Begins

2009-06-02T22:34:00.000-04:00

Graduation was a few weeks ago, I gave my notice at my job and the house is on the market. It has been a busy couple of weeks. This weekend marks the beginning of the good-byes, I'm off to Chicago to see a friend one more time before I head out. This is the hardest part of my decision, saying good-bye. I've never been a big fan of saying good-bye.

The reality of leaving is really setting in. It started when I was getting the house ready to show and has been an increasing reality dose ever since. Every day has become about transitioning. Packing items, selling furniture, mapping out a transition plan for work, updates and paperwork from the new job, and so the "to-do" list grows.

I have been trying to keep in mind that I don't need to worry because tomorrow will work itself out. Each day has enough trouble of its own.

Keep Smiling,

Jen